Most women find their periods come to an end between 40 and 58 years of age, with the average being 51 years. Officially, you’re considered to have entered menopause one year after your last period.

There’s no way of telling when you will start to experience symptoms, although if your mother entered menopause early, you have a higher chance of doing the same.

Leading up to menopause, it’s common for periods to become irregular. And during this time, some women start to experience some of the tell-tale symptoms. This can happen five to six years before periods end.

It’s also impossible to predict how severe or prolonged your symptoms will be. Each of us will experience menopause differently. About 20 per cent won’t experience any symptoms at all. But around 60 per cent will suffer mild symptoms for around five to eight years. But for about 20 per cent, the symptoms are so severe that their quality of life is badly affected.

Some women will suffer symptoms into their 60s, while an unlucky few will have them for the rest of their lives.

What you may feel

A recent UK study found the most common symptoms are:

hot flushes (40%)

night sweats (17%)

insomnia (16%)

vaginal dryness (13%)

mood disorders (12%)

weight gain (12%)

Hard things to talk about

Mood swings can be really debilitating. Some women find their behaviour becomes so irrational that it wreaks havoc on their friendships, their relationships and their job.

These mood swings can be worsened by sleep disturbances. Bad sleep can happen when you’re waking up with hot flushes or having night sweats. Your doctor may prescribe antidepressants to manage your moods.

Another less-talked about symptom is vaginal dryness. It can make sex uncomfortable or even painful. So, women may try to avoid sexual contact which has knock-on effects for their relationship. Happily, there is plenty that can be done to help, so it is worth chatting with your doctor.

With just a few small tweaks to your diet and lifestyle, many other symptoms can be eased without medication.

A weighty issue

During menopause, your body’s metabolism slows by around 10 per cent. This means that you run the risk of gaining weight unless you change your diet and increase your activity levels.

In the meantime, hormonal changes cause any excess fat to settle around your middle. This can predispose you to type 2 diabetes and heart disease.

Carrying excess weight can also worsen joint pain, hot flushes and night sweats. It may also increase your risk of developing certain cancers.

The good news is that a recent study has found that for every 5kg you lose, there is an impressive 30 per cent reduction in hot flushes.

Keeping it off

If you’re trying to lose weight, steer clear of fad diets. These often lead to rapid rebound weight gain (when you lose weight quickly but then put it all back on again after you stop dieting), and you risk being heavier than before you started dieting. These diets are rarely balanced, so they can make menopausal symptoms worse. It’s much healthier to follow a balanced diet of around 6300kJ (about 1500cal) which is 2400kJ (500cal) less than you need to maintain your weight — so that you lose weight slowly.

Enjoy more soy

Women experience fewer hot flushes in countries where soy is a large part of the diet. Soy foods contain phytoestrogens, which can act in the same way as oestrogen. Since hot flushes are caused by changing oestrogen levels, eating soy-rich foods such as tofu and soy milk can bring relief. It may even reduce the risk of developing heart disease. Try incorporating two 200ml glasses of soy milk or 100g of firm, soft or silken tofu into your day.

The phytoestrogens in soy work in some people to produce a compound called S-equol, which seems to alleviate hot flushes and other menopausal symptoms. You can buy S-equol supplements, however, more research is needed to measure how effective they are.

Boost bone health

Calcium

We lose calcium from our bones more quickly during menopause. Women over the age of 50 need to boost their intake from 1000mg to 1300mg of calcium a day. This means adding an extra glass of milk, two slices of cheese, or a tub of reduced-fat yoghurt every day.

Vitamin D

helps the body to absorb calcium, so it’s essential for strong bones. The best way to get your daily dose of vitamin D is by direct sun exposure. Just 5–10 minutes of gentle sun exposure daily during summer, with a little more in winter, is all you need.

Weight-bearing activity

One of the most effective ways to keep your bones strong is through weight-bearing activity, such as walking, dancing, tennis or tai chi. So aim to include this at least twice a week. You can also try using light hand weights at home.

Eat to reduce cholesterol

Blood pressure can also rise. Up until this point in your life, oestrogen has provided you with some protection against heart disease. But now, falling oestrogen levels combined with rising blood pressure and cholesterol increases your risk of heart disease.

To help protect you from all of this:

Keep your weight in check

Eat less sat fats (found in butter and processed meat)

Avoid trans fats (found in fried food and pastries)

Eat more foods rich in soluble fibre such as oats, whole grains, fruit and vegetables

Use foods fortified with plant sterols such as Flora Pro-activ spread and HeartActive™ milk

Eat more soy-based foods

Eat more oily fish, such as salmon, mackerel and sardines

Include a Mediterranean-type diet which contains plenty of fresh fruit and vegetables, fish, nuts and seeds

Cut down on alcohol, spicy foods and caffeine

Drinking alcohol makes hot flushes worse, and can also make your bones thin during menopause. Limit yourself to one standard drink (e.g. 100ml wine) per day and aim for two alcohol-free days a week.

Spicy foods and caffeine are also common triggers of hot flushes, so limit your intake of these.

What about complementary therapies?

At this time, there is no evidence that Chinese medicine and herbal treatments work in the long-term based on randomised controlled studies and trials.

Should you take HRT?

Hormone Replacement Therapy (HRT) can alleviate hot flushes, night sweats and vaginal dryness caused by menopause. Choosing to take it is an individual decision. Speak to your GP about the risks and benefits. And if you’re concerned about any symptoms of menopause, it’s worth chatting to your doctor.

Understanding your cancer risk

Your risk of developing breast cancer increases after menopause. Your diet can play a protective role, so make these changes: